Diabetes prevention in rural India

While communicable diseases like malaria and tuberculosis are only slowly being conquered, India is today experiencing a dramatic increase in the number of people suffering from diabetes and other non-communicable diseases.

India is having the highest number of people with diabetes in the world. In addition to the number already diagnosed, it is expected that an equal or even larger number of people have undiagnosed diabetes.

Virtually all diabetes efforts in India are currently focused in urban areas, while 70% of India's population actually lives in rural areas. Thus, the absolute number of people with diabetes in rural areas is in fact higher than in urban areas, and an increased focus on diabetes health care and prevention in rural areas is therefore urgently needed.

Objective

The aim of the project is to implement prevention of diabetes at primary, secondary and tertiary levels in a rural area of Tamil Nadu, India.

Approach

The project covers 4 phases:

In the first phase, a rural diabetes centre will be set up. Logistical issues such as recruitment of manpower and purchase of equipment will be addressed. Moreover, a network of stakeholders will be established, and the project will be promoted and publicized among health care professionals and the selected rural communities.

In the second phase, local volunteers will be educated and trained in order to increase their knowledge of diabetes and healthy living. The volunteers will include community health workers (e.g. school teachers and youth clubs) as well as village health workers (e.g. local women and self help groups). Subsequent to the training, the volunteers are expected to pass on the knowledge and skills acquired to their local communities and provide the local population with basic diabetes information.

In the third phase, screening for diabetes, impaired glucose tolerance and associated complications will be delivered at the doorstep of the rural population. A well-equiped mobil van will provide quality diabetes care to rural people, who would otherwise not have access to such facilities.

Primary prevention of diabetes will be the focus in the fourth phase and will be addressed through Information, Education & Communications (IECs). Innovative approaches to increase awareness and empowerment will be adopted. These include development of low cost information material, conduction of lectures and seminars for the lay public, public awareness campaigns, nutrition workshops for rural women as well as addressing target groups such as students and farmers.

Expected impact

• Approximately 200,000 rural people educated in diabetes and other non-communicable diseases
• 50,000 persons screened for diabetes
• 3,000 people with diabetes screened for diabetes complications
• 50 health workers trained to become diabetes educators
• A model for prevention of diabetes will be developed in this project

Results to date

• The Telemedicine van has been successfully used for all screenings and video conferencing activities as well as for treatment of diabetes and it complications in all 42 villages comprising the project area.
• 20,777 people above the age of 20 have been screened for diabetes in the 42 villages, corresponding to 79% of the targeted population. An additional 1,518 people in villages outside the project area have been screened.
• 1,323 patients have undergone retinal photography and been given tele-consultation by the ophthalmologist from the main centre. 226 were identified with diabetic retinopathy. 48 have been given laser treatment and the remaining patients are being counselled for laser therapy.
• Since its inception in 2007, the centre at Chunampet has registered and treated 3,036 patients for complications due to diabetes (eye, feet, kidney and heart). The centre has also provided consultations to 4,678 patients who have come for review treatment.
• A village health worker and a community health worker from each village have been selected and trained in various aspects of diabetes and its complications. The health workers work closely in the communities to collect health data from the population.
• Messages about simple and practical life style modifications, diabetes and its complications, risk factors and self care are conveyed through awareness lectures in Tamil organised by health workers or by group events such as skits and puppet shows. At the end of each session, handouts containing tips for diabetes prevention given to the participants.
• The new diabetes hospital building at Chunampet is almost ready and will have 2 rooms for consultant diabetologists and 1 room for an ophthalmologist.  

Project data

Area Partner Project responsible Duration Project budget WDF contribution Project number

Tamil Nadu, India Madras Diabetes Research Foundation Prof. V. Mohan November 2005 - November 2009 USD 1,162,571  USD 500,000 WDF05-115